Objective Serrated polyps (SPs) are an important cause of postcolonoscopy colorectal cancers (PCCRCs), which is likely the result of suboptimal SP detection during colonoscopy. We assessed the long-term effect of a simple educational intervention focusing on optimising SP detection. Design An educational intervention, consisting of two 45 min training sessions (held 3 years apart) on serrated polyp detection, was given to endoscopists from 9 Dutch hospitals. Hundred randomly selected and untrained endoscopists from other hospitals were selected as control group. Our primary outcome measure was the proximal SP detection rate (PSPDR) in trained versus untrained endoscopists who participated in our faecal immunochemical test (FIT)-based population screening programme. Results Seventeen trained and 100 untrained endoscopists were included, who performed 11 305 and 51 039 colonoscopies, respectively. At baseline, PSPDR was equal between the groups (9.3% vs 9.3%). After training, the PSPDR of trained endoscopists gradually increased to 15.6% in 2018. This was significantly higher than the PSPDR of untrained endoscopists, which remained stable around 10% (p=0.018). All below-average (ie, PSPDR ≤6%) endoscopists at baseline improved their PSPDR after training session 1, as did 57% of endoscopists with average PSPDR (6%–12%) at baseline. The second training session further improved the PSPDR in 44% of endoscopists with average PSPDR after the first training. Conclusion A simple educational intervention was associated with substantial long-term improvement of PSPDR in a prospective controlled trial within FIT-based population screening. Widespread implementation of such interventions might be an easy way to improve SP detection, which may ultimately result in fewer PCCRCs. Trial registration number NCT03902899.

中文翻译：

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简单的教育干预后锯齿状息肉检测的实质性和持续改进：前瞻性对照试验的结果

目的锯齿状息肉（SPs）是结肠镜检查后结直肠癌（PCCRCs）的一个重要原因，这可能是结肠镜检查中SP检测不理想的结果。我们评估了侧重于优化 SP 检测的简单教育干预的长期效果。设计 对来自 9 家荷兰医院的内窥镜医师进行了教育干预，包括两次 45 分钟的锯齿状息肉检测培训课程（相隔 3 年）。随机选择其他医院未经培训的内镜医师 100 人作为对照组。我们的主要结果测量是参加我们的基于粪便免疫化学测试 (FIT) 的人群筛查计划的受过培训与未经培训的内窥镜医师的近端 SP 检出率 (PSPDR)。结果 包括 17 名受过培训和 100 名未经培训的内窥镜医师，他们分别进行了 11 305 和 51 039 次结肠镜检查。在基线时，两组之间的 PSPDR 相等（9.3% 对 9.3%）。经过培训，经过培训的内窥镜医师的 PSPDR 在 2018 年逐渐上升至 15.6%。这明显高于未经培训的内窥镜医师的 PSPDR，后者稳定在 10% 左右（p=0.018）。所有低于平均水平（即 PSPDR ≤ 6%）的基线内窥镜医师在第 1 次训练后都改善了他们的 PSPDR，57% 的基线平均 PSPDR (6%–12%) 的内窥镜医师也是如此。在第一次培训后，第二次培训课程进一步提高了 44% 具有平均 PSPDR 的内窥镜医师的 PSPDR。结论 在基于 FIT 的人群筛查中的一项前瞻性对照试验中，简单的教育干预与 PSPDR 的显着长期改善相关。广泛实施此类干预措施可能是改善 SP 检测的一种简单方法，这可能最终导致更少的 PCCRC。试验注册号 NCT03902899。